耳蜗局灶性缺血模型介入溶栓的初步研究  

Intra-arterial thrombolysis for the treatment of restricted cochlear microcirculation disorder in guinea pigs

作　　者：钟贞[1] 李学佩[2] 吴红涛[3] 

机构地区：[1]北京大学第一医院耳鼻咽喉头颈外科,100034 [2]北京大学第三医院耳鼻咽喉头颈外科 [3]九江市第一人民医院耳鼻咽喉科

出　　处：《中华耳鼻咽喉科杂志》2003年第1期24-28,共5页Chinese Journal of Otorhinolaryngology

基　　金：卫生部科学研究基金资助项目 (98 2 2 2 7)

摘　　要：目的　探讨介入溶栓对耳蜗局灶性缺血动物模型治疗的有效性。方法　将豚鼠分为造模组、介入溶栓组 (A组 )、静脉溶栓组 (B组 )及相应的 2组盐水对照组 (A1、B1组 )。均用光化学法诱导左侧耳蜗第二回外侧壁 1 2mm× 1 0mm范围内形成微血栓 ,3 0min后A组通过经左锁骨下动脉置于椎动脉起始部的导管向左侧椎基底动脉内推注尿激酶 (urokinase ,UK) ,总量为 7× 10 4 U/kg,用微量泵维持其推注时间为 10 0min ;B组通过左颈外静脉推注UK ,用量用法同A组。连续监测动物耳蜗血流与耳蜗电图动作电位阈值的变化 ,并观察各组动物光化学诱导后 3h的耳蜗血管纹铺片和基底膜铺片。结果　A、B组观察时间内与造模组和A1、B1组相比 ,耳蜗血流、动作电位阈值及毛细胞坏死的情况均得到改善。在给UK后 5 0min ,A组的动作电位阈移值低于B组 (P =0 0 2 5 ) ,这种差异保持了3 0min。溶栓治疗 80～ 90min ,A组的耳蜗血流出现下降的趋势 ,动作电位阈值也有增高的趋势。结论介入溶栓与静脉溶栓对于耳蜗局灶性血栓都有疗效 ;Objective To ascertain a new treatment method for restricted cochlear microcirculation disorder. Methods Photochemical reaction was utilized to induce localized microcirculation damage to the second cochlear turn of every guinea pig The animals were divided into 5 groups Group 1 was blank control Group 2 and Group 3 were injected urokinase (UK) through left subclavian artery or left external jugular vein 30 minutes after photochemical reaction Group 4 and Group 5 were two control groups Instead of urokinase, saline injection was applied accordingly Results Both intra arterial thrombolysis and intravenous thrombolysis were effective to improve the hearing levels and the blood supply to the inner ear 50 minutes after urokinase injection, animals with intra arterial thrombolysis showed a lower action potential threshold than that with intravenous thrombolysis( P =0 025) And this phenomenon lasted 30 minutes Cochlear blood flow of the animals with intra arterial thrombolysis began to decrease and action potential began to increse 80 90 minutes after UK injection Conclusion Both intra arterial thrombolysis and intravenous thrombolysis were effective to the restricted thrombosis in the stria vascularis, and intra arterial thrombolysis showed a better improvement in the early stage of thrombolysis

关 键 词：耳蜗局灶性缺血 介入溶栓 微循环 血栓溶解疗法 疗效 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]